Background: This study was conducted to investigate whether uterine artery spectral Doppler screening is able to identify patients who will develop hypertensive disorders in pregnancy (HDP). Besides HDP, delivery of SGA babies, their APGAR scores and whether admitted in NICU is also studied.

Methods: In this single-centre prospective cohort study, 200 low-risk antenatal women attending a tertiary care teaching hospital in eastern India between July 2020 and August 2023 underwent transabdominal uterine artery Doppler assessment at 11–13+6 weeks. Mean pulsatility index (PI), resistance index (RI), and systolic/diastolic ratio were recorded; the 95th percentile was used to classify women as Doppler-normal or Doppler-abnormal. Participants were followed prospectively for development of HDP, delivery of a small-for-gestational-age (SGA) neonate, neonatal intensive care unit (NICU) admission, and APGAR scores. Groups were compared using the independent-samples t-test for continuous variables and the chi-square or Fisher exact test for categorical variables; P < 0.05 was considered significant.

Results: Twenty-four women (12.0%) had abnormal first-trimester Doppler indices. HDP developed in 18 women overall and 16 of these had abnormal Doppler findings. HDP occurred in 66.7% of the Doppler-abnormal group versus 1.1% of the Doppler-normal group (P < 0.001). Abnormal Doppler was also associated with a higher rate of SGA neonates (25.0% vs 5.1%, P = 0.001) and NICU admission (50.0% vs 23.9%, P = 0.007).

Conclusion: Abnormal first-trimester uterine artery Doppler velocimetry was strongly associated with subsequent development of HDP and with SGA and NICU admission in this low-risk cohort. These findings support incorporation of first-trimester uterine artery Doppler into routine antenatal screening to identify women who may benefit from closer surveillance and prophylactic low-dose aspirin, although confirmation in larger, multicentric cohorts with a priori sample size calculation is required.

KEYWORDS: Pregnancy-induced Hypertension, Pre-eclampsia, Uterine Artery Doppler, Pulsatility Index, First trimester Screening, Small for Gestational Age.